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Welcome back to part 2 in the asthma series. In Part 1 we looked at some of the likely causes which present themselves with asthma along with the conventional treatment. Let's take a look at some of the natural ways we can help a person diagnosed with this common complaint. Asthma and Breathing Deep breathing will help improve asthma, but only if practiced regularly. If you have any breathing issues such as asthma or recurrent chronic bronchitis, then regular exercise in general such as walking, swimming, yoga, Tai Chi, and relaxation exercises can help profoundly to deepen and relax your breathing. Whilst some of these techniques may be more difficult for a child, swimming is excellent, more on this later. Stress has an amazing way of increasing our heart and respiratory rates, and I've noticed that stress and anxiety seem to be a common with many asthmatics. It makes sense to learn to relax, and once the asthmatic learns to relax a lot more their breathing often improves a lot. Some of the best health books I have seen are the older ones, including a little publication from 1963 called "Asthma and your Child" by New Zealand Physiotherapist Bernice Thompson. Her book was so successful that the NZ National Film Unit actually made a film from it on breathing exercises for children. Some people have told me over the years that older health books are "out dated" and why do I bother to refer to them. I'll tell you why, these valuable older books were written by practitioners in by gone days, in an era long before drug companies started their marketing drives. In the "old days", practitioners spent a lot more time with their patients and many taught effective techniques and home procedures and also encouraged foods which positively affected their patient's health. People also had more time generally, had to rely on home remedies and were much more hands on with their children than most parents are familiar with today, especially with respiratory and digestive problems. Just ask your grandmother, she will be quick to tell you about how her mother used all sorts of remedies which she was taught herself. It was common for example to give a baby an enema if it was "blocked up". Antibiotics were literally unheard of in the early 60's in clinical practice and puffers were not employed as yet. The powerful tiny antibody commonly involved in asthma responses (called IgE) was only discovered in 1966, before this they had no clue of what was involved with asthma in terms of immunity. And funnily enough, asthma back then was a rather rare phenomenon. Incredible as it may seem, even asthma itself has been linked today to the overuse and abuse of antibiotics, aspirin, paracetamol and the asthma drugs themselves. Bernice Thompson states in her little self-help asthma book: "I want to show you how you can help your child, the intelligent use of breathing exercises is one of the most important factors in improving a child's respiration, and when used correctly these exercises will always improve the

child's whole physical set-up. In fact, in many cases the asthma itself can clear up altogether". Well, what happened today? Children are today not commonly taught any breathing exercises when they are diagnosed with asthma or have recurring respiratory complaints, except the effective use a puffer because "asthma is a dangerous condition" and that as a responsible parent you should encourage daily use of medications. Remember I spoke last month about how effective "fear mongering" has become with conditions such as asthma? Instilling a child's parents with fear, like those vaccine campaigns guilt tripping parents with scenes of choking babies turning blue will ensure that millions more drug prescriptions will be continually sold by companies who effectively use fear as a weapon to market their profitable drugs, with little regard to how they can improve a patient's condition with healthy diet and lifestyle choices. Dr. Buyteko's method Russian Professor Buteyko developed a simple, drug-free treatment for asthma and other diseases after he noticed that over-breathing disturbs the metabolism and makes the body more prone to illness. Dr. Paul Ameisen is an Aussie doctor who has been able to make a study of over 8,000 patients treated so far in Australia, and his book, Every Breath You Take, was the result of six years of research into the Buteyko method and the results it has achieved for asthma sufferers. The results are astonishing and suggest a direct link between our breathing patterns and our level of health. In 1995 a randomised double blind placebo controlled study on the Buteyko method was run in Brisbane, from the data given the reduction in beta2-agonists (e.g. Ventolin(TM)) was a staggering 96% and the reduction in steroid inhalers was 49%. The trial showed that the Buteyko method reduces drug usage profoundly without exacerbating the disease and without deterioration in lung function. In 2000 another trial took place in New Zealand, and again, amazingly there was an 85% reduction in beta2-agonists and a 50% reduction in steroid use amongst people who had used the Buteyko method for six months. The British Guideline on the Management of Asthma 2008 has granted permission for British health professionals to recommend the Buteyko method. No other complementary therapy has ever been endorsed by this strict body for the treatment of asthma. By the early 1980s, Russian authorities were sufficiently impressed with Buteyko's results to allow him a formal trial with asthmatic children in a Moscow hospital, and the results were impressive enough to persuade the State Medical System to approve the method for widespread Russian use. Then why not is NZ embracing this system widely within the medical system, which has proven to be of enormous benefit for the asthmatic you ask? Why should any Western country ever approve an effective non-drug solution to asthma when one of the world's most popular asthma drugs will make almost 9 billion US dollars this year? What is the Buteyko method? The Buteyko theory is that the basic cause of asthma is a habitual, hidden over-breathing (literally, taking in too much air when breathing). The treatment is based on bringing the breathing to normal levels and thus eradicating over-breathing (hyperventilation) and reversing the need for the body's defence mechanisms. These defence mechanisms, according to the theory, include spasm of the airways, mucus production (in the chest, nose, throat and ears), and inflammation (swelling) of the bronchial walls. The Buteyko method's message is that when asthma sufferers learn to alter the volume of air they habitually inhale, their asthma attacks can be significantly reduced and the use of asthma drugs and apparatus can be reduced or entirely eliminated by 90% or more.

Here is my clinic handout describing the Buteyko technique: The four Buteyko exercises 1. Breathe in and out, both through the nose only. To reduce over breathing try to use your nose and not your mouth. 2. Tape the mouth up whilst sleeping. Don't laugh! Unless there is some severe nasal condition, this should not represent any problem and should be adopted for the first few weeks at least to encourage nose breathing. Adults can easily adapt to this, but for children this concept frightens parents easily. However, doctors and Buteyko practitioners worldwide have not seen any harm come to children after recommending this practice for many years. Partial taping can be practiced until children and parents become more confident. Use a light, easily removable micro pore tape. 3. Sleep on the left side. Avoid sleeping on the back. Sleeping on the back causes the most overbreathing Professor Buteyko's research has shown that sleeping on the left-side causes the least over-breathing. 4. Increase your Control Pause. The control pause is described as the time it takes someone to breathe out normally, then to hold his/her breath in the out position until the very first signs of discomfort occur. This measurement is recorded then the person continues to breathe through the nose in a shallow pattern. Most people can only achieve 10 to 20 seconds, at rest. Some cannot even achieve one second, while others can easily achieve 40 seconds! The idea is too eventually to succeed in holding the breath in the out position for up to 50 to 60 seconds, until first difficulty is reached, to achieve the desired improvement. This is the measure of success with the Buteyko method. A person with a control pause of 15 seconds is breathing a volume of air per minute that is enough for 4 people. A person with a control pause of 30 seconds breathes for 2 persons; a control pause of 60 seconds indicates correct breathing, i.e., for 1 person. 5. The Maximum Pause. The maximum pause is the time it takes a person to breathe out normally, hold his/her breath in the out position and, through specially taught distractions, prolong this pause to the maximum time. With exercise, repetition and perseverance, some people surprise themselves with times of up to two minutes or even longer. It is considered ideal to practice the control & maximum pause alternatively for 20 minutes a day; results come quickly to those who persevere. Swimming is an excellent activity for the asthmatic to do on a regular basis, because it allows the body to better balance the levels of oxygen and carbon dioxide due to the fact that a swimmer will hold his or her breath for extended periods. Swimming is one of the best ways to practice the maximum pause in a natural setting, and makes a lot of sense to me. Eric's 10 step Asthma Plan Check for likely causes. If you look at each individual case, it doesn't take long to establish one or possibly more causes. If you can't establish a likely cause with a health problem like asthma, you are unlikely to be able to correct or modify it which will mean you will be treating the symptoms with drugs, and sometimes long-term. We spoke about stress and emotional causes, environmental, heavy metal toxicity, postural problems and more last month. Decrease or avoid known traumas and emotional triggers family environment, dependency issues of the child.

1. Is it really asthma? It is true, I have seen many young patients over the years who were diagnosed with asthma, but once we found the trigger/s (see part 1) the case was solved because lung function improved and drugs like puffers and antibiotics were no longer necessary. My son was diagnosed as being "asthmatic" but was in fact dairy intolerant. You need to be strong as a parent, when I spoke to my doctor many years ago about not wanting to vaccinate my son, we were told that we were "irresponsible" and I would regret my decision one day when our child was lying in a hospital bed dying of a "perfectly preventable disease". Make absolutely certain that you have tried other means to improve your child's lung function, before launching into drugs. Look for the cause; improve their diet and emotional health and their environment first. 2. Stop being so "germ phobic". Television is a great way to get people hyped up, look at those advertisements about germs and how clean we should live. I'm not suggesting living in a filthy house, but researchers now suggest that a growing obsession with disinfecting everything in sight may help explain the rise of asthma over the past couple of decades. One hundred years ago, more people lived on farms, hygiene was poorer, and there were no bacteria-killing drugs and asthma was hardly around then. In essence, the modern phenomenon of placing children in sterile environments and giving those antibiotics for the tiniest sniffle has helped make them far more susceptible to asthma, as well as creating bacteria strains which are today almost totally antibiotic resistant. It is NOT the big bad bugs that we are exposed to that actually cause most of the health problems like asthma that we have. Rather it is related to factors that suppress our immune system such as a poor diet, lack of emotional support, and exposure to poisons and toxins like immunisations, food additives, mercury and petrochemicals. 3. Breastfeed your child Investigators found that children who were breast-fed in the first weeks of life had a much lower asthma risk. They also linked breast-feeding with lower risk because breast milk provides immune factors not present in formula. And when the formula is introduced, what is in it? That's right, cow's proteins, which are in fact the most allergenic food you can possibly give a child. Experts estimate that not breast-feeding can be blamed for as many of 16% of all asthma cases. Asthma incidence is far greater in the Western world than the undeveloped countries (with all their germs), possibly due to the fact that women here feed their kids on the breast for up to 5 years. Many women I see have to go back to work, and are lucky to breastfeed for 12 weeks. Breast is always best. 4. Giving the lowest possible amount of drugs to control the symptoms. It surprises me how much medicine asthmatics are told to take on a daily basis to "control" their asthma. Western medicine seems more about "control" of symptoms rather than allowing the patient to make sensible choices allowing their body's own innate ability to self-correct. When the patient is in control of their asthma (rather than the drug) they can begin to lessen their dependence on drugs and may even be able to stop the drugs altogether, thereby breaking the cycle of drug dependence leading to symptom suppression. Are drugs the answer? Sorry, but I'm going to do some of my own fear mongering: A recent meta-analysis of the roles of long-acting beta-agonists indicates their danger to asthma patients. The study (Annals of Internal Medicine 2006) found that long-acting betaagonists increased the risk for asthma hospitalisations and asthma deaths 2 to 4 times when compared with placebo. What doesn't surprise me is that The New York Times (USA newspaper: November 2007) reported a review of more than 500 studies finding that independently backed studies on inhaled corticosteroids are up to four times more likely to find adverse effects than the studies paid for by drug companies.

5. Breathing technique such as the Buteyko method is paramount, particularly for those chronic patients who may take puffers every few hours during of the day. Most "puffer dependent" patients can quickly learn how to breathe more efficiently and reduce their need within weeks. I have been teaching asthmatics the basics of the Buteyko method for over ten years and seen wonderful results. It is really true; many patients (clinical trials showed between 85 and 96%) can throw their Ventolin(TM) puffer away in time. Ask your naturopath if he or she can help you, or can refer you preferably to a qualified Buteyko practitioner. 6. Back and chest massage, with particular emphasis on strokes which open out the chest and shoulders. Aromatherapy can be quite helpful in dealing with asthma because a number of essential oils have calming and antispasmodic effects that can encourage emotional balance, ease the struggle to breathe, and cause bronchodilation. During an actual crisis, inhaling an antispasmodic oil is of good help, and direct sniffing from the oil bottle (with supervision) or give a small bottle with a plastic insert from only which a drop can be dispensed, or put a few drops on a tissue or handkerchief, particularly with a child. The choice of essential oils will depend on many factors such as whether or not there is infection present, or whether emotional factors are involved, ask a good aroma therapist. Some of my favourite oils with asthma are cajuput, cypress, eucalyptus and lavender. Be careful because some asthmatics may react strongly to essential oils, so trial carefully first. 7. Diet changes: Diet can be a hidden source of many problems for the asthmatic. The early onset of asthma is sometimes even triggered by a child not being breast-fed at all, or only having been breastfed for a few weeks and then placed on a cow's based infant formula. With adults, a source of concern is alcohol and preserved fruit, which may contain sulphur dioxide. An asthmatic who is particularly sensitive may even react to as little as a few parts of sulphur dioxide per million! o A restrictive low-allergen diet for the first 12 weeks to see if there is any food involvement. And/or Szentivanyi first described the "Beta Adrenergic Theory of Asthma" in 1968; in which a blockage of certain receptors in the lungs (Beta-2 receptors) actually causes asthma. Szentivanyi's theory is now considered a medical classic and has been mentioned more times than any other article in the history of the prestigious Journal of Allergy. In 1995, Dr. Szentivanyi demonstrated that the immunoglobulin IgE (the most powerful antibody involved in allergies) actually blocks beta-2 receptors. Since overproduction of IgE is central to allergic diseases, this was a quantum leap in the world of understanding allergies. Now think about this, there are some foods which stimulate a strong IgE response in the body; does it therefore not make good sense for the asthmatic to avoid them as much as possible, at least initially as a trial? I generally recommend the removal of the following foods temporarily, because they have been shown through clinical experience to aggravate the immune system of an asthmatic and eczema sufferer who typically has a "trigger happy" IgE responsive immune system. These foods include dairy products (particularly cow's milk, yoghurt and those yummy dairy ice creams, chocolates, peanuts, nuts in general, bananas and oranges. This food group may also include avocado, corn, eggs and wheat, but first see if the other foods are involved. I often tell parents to watch their child and see which food/s they want the most, because there will often be a food they strongly desire which belongs to the allergenic group. For children who are in separated family situations, take care when they go to dad's place for example on the weekend. I have seen a few children develop "mysterious coughs" on a Monday or Tuesday after dad got them a double scoop ice cream on a Sunday. The child's mother may well have them on a restrictive diet and adhere to a strict regime

of dairy avoidance, so checking out when the asthma is at its worst can help a lot to establish the triggers. Watch grandma or grandpa or aunty too, they may think it "unfair" that you are depriving the kids of treats, not fully understanding the immune involvement with an asthmatic and may potentially undo all your good work, so be firm. o Be aware of food intolerances. Keep your child away from those pesky dairy and supermarket counters as they can be a real trap and will only encourage your child to pester you for sweets until you usually give in. Sugar has an interesting effect on the immune system; it actually depresses it and by its acidic nature in the body only encourages the production of sticky mucus. Other mucus forming, clogging and devitalised foods to avoid are cow's milk and other dairy products (which we have already covered under immune trigger foods), white breads, soft drinks and those sugary sachets which make up sweet drinks, chewing gum and junk foods. Give your child less red meat temporarily, because it comes from the cow which also produces allergenic milk, and give more fresh fish or chicken or egg which is lighter and more easily digested protein sources. o Eat more anti inflammatory foods. Pineapple contains an enzyme called bromelain, onions and kelp contain a flavonoid called quercetin, and grapefruit contains naringin, an anti inflammatory flavonoid, all of these foods can help reduce inflammation in the body. Methionine is an amino acid found in protein rich foods, and it binds to excess histamine, making immune reactions much less severe. Grade-A proteins contain large amounts of methionine, and include tuna, mackerel, herring, sardines, salmon, chicken and tofu. Avocado, sesame seeds, pumpkin seeds and sunflower seeds on the other hand are rich in vitamin E, which has been found helpful in calming inflammation in the lungs as well. o Watch the fats in your child's diet - give Omega 3 daily. Toddlers who consume large amounts of margarine and foods fried in vegetable oil may be twice as likely to develop asthma as their peers who eat less of these foods. (Thorax August 2001;56:589-595 ) Diets high in polyunsaturated fat (found in margarine, vegetable and sunflower oils) boost levels of omega-6 fatty acids in relation to levels of omega-3 fatty acids (fish oils). Omega-6 fatty acids contribute to the production of compounds involved in inflammation and may therefore contribute to inflammation of the airways. Omega-3 fatty acids -- found in fish and fish oil supplements, inhibit inflammation on the other hand. This could explain why kids from lower income families living on foods like white breads, margarine and jam are much more prone to asthma. Give Omega 3 fish oils supplement daily to any child with asthma please; you are making a huge difference here. 8. Build immunity to reduce need for antibiotics. To reduce the need for antibiotics to treat infections which are commonplace with asthmatics, use nutrients to bolster the person's own immune system. These may include liberal use of vitamin C, vitamin A, zinc, copper, iron and glandular extracts. Taking a good pro-biotic is another way to build excellent immunity, and recent research validates this. See your naturopath for the right strain of pro-biotic rather than buying just one over the counter. There are many types now available and a "practitioner-only" is one I would recommend over the ones you buy at your health-food shop. 9. Herbal medicine, For asthma I would commonly use herbal medicines like grindelia, adhatoda, wild cherry, licorice, aniseed, goldenseal, echinacea, marshmallow, and various others. I can thoroughly recommend a visit to a good herbalist. Herbs are best taken several times daily and can really help with breathing difficulties as well as help to effectively treat the infections which an

asthmatic is prone to. Why take antibiotics? I have always treated my 4 children with their winter coughs and colds with herbs and not once ever resorted to antibiotics with any of them. Herbs don't have to taste foul either, ask for a "glycetract" formula, nice and sweet and the compliance with children is increased considerably. 10. Nutritional medicine. The main nutrients I have found through my studies which can positively affect the asthmatic include vitamins C, B6 and B12, magnesium, zinc, iron and selenium. The addition of a high quality multi vitamin and mineral supplement is recommended to counter any deficiencies here. In addition, a porcine glandular extract can have a most positive effect on the asthmatic's immune system by helping to normalise the hypothalamic-pituitary-adrenal axis, (the body's innate stress response) by allowing cortisol, the powerful immune-boosting hormone produced by the adrenal gland, to normalise, which in turn will "down regulate" an over stimulated immune system (IgE). The end result is that the IgE responses eventually settle right down. A glandular extract is a particularly helpful addition if steroidal "preventative" puffers have been used for some time. Why? Because steroidal drugs effectively suppress the body's production of its own steroidal (adrenal) hormones, allowing the immune response in one sense to be suppressed, thereby "preventing" an asthma attack, but on the other hand allowing the hypersensitivity (IgE) responses to continue unabated by suppressing the production of cortisol. I have personally verified this glandular approach clinically now for the past two years and even witnessed one severe asthmatic's peak flow volumes more than double in less than twelve weeks. The doctor was astonished to say the least, and quickly weaned the patient off more than four different antibiotics. When you have asthma as severe as this lady (more than 40 years), you get to the point where you become permanently dependent on steroids and antibiotics because you are always sick. Your bones begin to crumble and your skin becomes as thin as tissue paper as the Prednisolone takes its toll. Ask your practitioner, as adrenal glandular extracts are again "practitioner only" and not available in the health food shops. Treating asthma can be a most difficult and frustrating endeavour, especially for the parent. However, the above mentioned environmental modifications, Buteyko method, dietary avoidances, nutritional supplements and herbs can in combination dramatically help to reduce the overall burden. In many cases, my 10 step asthma plan can help prevent the asthmatic from even having to use beta-agonist bronchodilator or steroidal puffers, or they can be used as an adjunct to these drugs to allow lesser usage or lower drug dosing. However they are used, it is important for the practitioner to fully investigate the patient's reactivity to substances in their diet and environment and promote avoidance of those substances, as well as encouraging proper nutrition and lifestyle practices that will reduce the overall immune burden. You can make a real difference here, and asthma truly is one of those chronic conditions where the best results will come with an integrated and holistic approach.

Mr. Eric Bakker is a registered Naturopath with a Bachelor Degree of Science majoring in Complementary Medicine as well as separate diploma qualifications in Naturopathy, Herbal Medicine and Classical Homeopathy. Eric is past Vice President of the New Zealand Natural Medicine Association with almost 20 years of clinical experience in natural medicine and has had extensive post graduate training in Australia, America, New Zealand and India.

Mr. Bakker lectures at natural medicine colleges and natural health conferences throughout Australia and NZ, writes for several journals and natural health publications and specialises in the clinical integration of natural and conventional medicine. Eric has practiced in conjunction with medical doctors for over 13 years in medical clinics in both NZ and Australia. Mr. Bakker specialises in the clinical integration of natural forms of healing and conventional Western Medicine. Eric is the Clinical Director of The Naturopaths and has a clinical practice in the Hawke's Bay, New Zealand. Your best way to contact Eric is by way of email: eric@naturopath.co.nz His website is: http://www.naturopath.co.nz Eric's NEW website will be coming very soon, his old one is being revamped right now!

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